NPIMap

Organization Active NPI

Ringgold County Hospital

Doing business as Mount Ayr Medical Clinic

  • Rural Health Clinic/Center
  • Mount Ayr, IA
National Provider Identifier
1154720878
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
RINGGOLD COUNTY HOSPITAL
Doing business as
Mount Ayr Medical Clinic
Practice address
504 N Cleveland St
Ste M
Mount Ayr, IA 50854-2201
Phone
(641) 464-4470
Fax
(641) 464-4414
NPI assigned
Aug 19, 2014
Last updated
Aug 22, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
RINGGOLD COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Teresa A. Roberts
Title
Cfo
Phone
(641) 464-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

504 N Cleveland St
Ste M
Mount Ayr, IA 50854-2201

Mailing address

504 N Cleveland St
Mount Ayr, IA 50854-2201
Phone (641) 464-4422

Other names 1

  • Mount Ayr Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150513000809 IA Part A Provider - Rural Health Clinic 7315849973 Practice locations: Mount Ayr, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154720878. Details of each certification follow.

Rural health clinic certification: CCN 168570

Legal name
RINGGOLD COUNTY HOSPITAL
Doing business as
MOUNT AYR MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 2, 2015
Last certification
Jul 13, 2018
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
504 N Cleveland St
Ste M
Mount Ayr, IA 50854-2201
Related CCNs
161373

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Emergency Care8 organizations share this tax ID, including this one
Part of
Spectrum Emergency Care

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

202 Dunning Ave
Mount Ayr, IA 50854
Phone (641) 464-2330

504 N Cleveland St
Ste M
Mount Ayr, IA 50854
Phone (641) 464-4470

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karleen a Stephens Individual Corporate Director Jan 17, 2011
Christopher J Elwood Individual Corporate Director Jan 23, 2023
Melissa D Walter Individual Corporate OfficerCfo Jan 1, 2019
W-2 Managing EmployeeCfo Jan 1, 2019
Operational/Managerial ControlCfo Jan 1, 2019
Edward R Daily Individual Corporate Director Sep 16, 2019
Contessa R Barnes Individual Corporate Officer Jan 23, 2023
Corporate Director Jan 19, 2015
Mercy Health Network Inc Organization, Clive, IA Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 2012
Leslie Dredge-Murphy Individual W-2 Managing EmployeeRHC Manager Sep 2, 2015
Operational/Managerial ControlRHC Manager Sep 2, 2015
Greg a Jobe Individual Corporate Director Jan 19, 2009
Kathleen Q Willcox Individual W-2 Managing EmployeeMedical Director Dec 13, 2021
Operational/Managerial ControlMedical Director Dec 13, 2021
Michael L Hopkins Individual Corporate Officer Jan 19, 2015
Corporate Director Jan 21, 2013
Nicholle Gilbertson Individual Contracted Managing EmployeeCeo Apr 3, 2023
Corporate OfficerCeo Apr 3, 2023
Operational/Managerial ControlCeo Apr 3, 2023
Kimberly a Bishop Individual Corporate Officer Jan 23, 2023
Corporate Director Jul 25, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 98

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 98

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1154720878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N CLEVELAND ST",
            "city": "MOUNT AYR",
            "state": "IA",
            "postal_code": "508542201",
            "telephone_number": "641-464-4422",
            "fax_number": "641-464-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N CLEVELAND ST",
            "address_2": "STE M",
            "city": "MOUNT AYR",
            "state": "IA",
            "postal_code": "508542201",
            "telephone_number": "641-464-4470",
            "fax_number": "641-464-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RINGGOLD COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RINGGOLD COUNTY HOSPITAL",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "641-464-4422",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Ayr Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Ayr, IA

Sources for this page

Verify at the official NPI Registry.